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ELDERBERRY HGTS 4TH BK 5 LT 7 - ZCPKodiak Island Borough Community Development Department 710 Mill Bay Rd. Rm 205 Kodiak AK 99615 Ph. (907)486 - 9363 Fax (907)486 - 9396 http://www.kodiakak.us Zoning Compliance Permit Print Form 1 1111 1111 16051 11 1 i_Submit by Email___1 111 Permit No. CZ2015-074 Property Owner / Applicant: Mailing Address: Phone Number: Other Contact email, etc.: Legal Description: Street Address: Use & Size of Existing Structures: The following information is to be supplied by the Applicant: Robert Casey 1619 Lynden Way, Kodiak, AK 99615 (907) 351-8420 Subdv: Elderberry Heights, 4th Addition 1619 Lynden Way, Kodiak, AK 99615 Block: 5 Lot: 7 :Single-family residence = Description of Proposed Action: Removal of 2' x 10.5' portion of rear deck and construction of a 2' x 17.5' addition and 3' x 4' stairs to rear deck as depicted on attached site plan. Finished deck size will be 8' by 28'. Site Plan to include: Lot boundaries and existing easements, existing buildings, proposed location of new construction, access points, and vehicular parking areas. Staff Compliance Review: Lot Area: 7,659 sq. ft. Current Zoning: R2 KIBC 17.80 Front Yard: 25 PROP _ID 16051 Lot Width: 60' Bldg Height: 35 Rear Yard: 10' Side Yard: 5' Prk'g Plan Rvw? Not Applicable # of Req'd Spaces: Staff Compliance Review Notes: Plat / Subdivision Requirements? Subd Case No. S83-12 Plat No. 8423 BId'g Permit No. TBD Does the project involve NO an EPA defined facility? Driveway Permit? Septic Plan Approval: Fire Marshall: N/A N/A N/A If YES, do you have an EPA Return Receipt of Notification? "Permit will not be issued until receipt is submitted to NO Applicant Certification: I hereby certify that I will comply with the provisions of the Kodiak Island Borough Code and that I have the authority to certify this as the property owner, or as a representative of the property owner. I agree to have identifiable corner markers in place for verification of building setback (yard) requirements. Attachments? Site Plan Date: Jun 11, 2015 List Other: N/A Signature: Robert Casey This permit is only for the proposed project as described by the applicant. If there are any changes to the proposed project, including its intended use, prior to or during its siting, construction, or operation, contact this office immediately to determine if further review and approval of the revised project is necessary. THIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING PERMIT IS REQUIRED. ** EXPIRATION: Any zoning compliance permit issued is subject to the same expiration, suspension, and revocation provisions as a building permit issued for the same construction permit. ** CDD Staff Certification Date: Jun 8, 2015 CDD Staff: Jack Maker Payment Verification Zoning Compliance Permit Fee Payle in Cashier's Office Room # 104 - Main floor of Borough Building Not Applicable Less than 1.75 acres: 1.76 to 5.00 acres: 5.01 to 40.00 acres: 40.01 acres or more: $0.00 $30.00 IJ $60.00 • $90.00 • $120.00 After - the -Fact 2X the published amount n. $0.00 El $60.00 fl $120.00 ❑ $180.00 • $240.00 JU® 11 2015 KODIAK ISLAND BOROUGH FINANCE DEPARTMENT L � t. . ,t 4p0 f7ELO c/1 k O . UPO9Th;P 4.6E/07:1087 216.. OEees ,ADDED mj/t,Eer !toed# ac0 3� T.vAnprPa a"r MAK fOS' Se4Br T1ED, FIELD CWECKE© and UP -DATED 19 bEEEM ER 1359 - 67scs cyANNEp; P /6L TANK / 1F7 4JNW& WALL and RecteRY 4o.o9p. ZZ L CHECKED and UP-G4 Z7, 1 1T q. (wow, 777 opus) AS BUILT SURVEY i"t e.49 t vf r xtPas Secs •• •7 s ?oy A. Ee!::vad e� % ♦ ,pf as NO. 13a3S . •a�i { Q04 ..eMN•.��9 "i 1:41:4.0 suss. FyF asM ... '� a ssi00- ,fir ] kartily certify that 1 have coney the fd]awiag deacribed propetry texiL Ts block 5. El .2r-bar 51..rbe ¢ .4Sdi7.. old that the improvements situated thereon are within the property line: and do not overlap or encroach on the property lying adjacent thereto that na improvements an property lying adjacent thereto encroach or thr Prtmaes in question and that there are no roadways. transmia ,sicn lines or other risible easements on said property except as 1ndi. cared hereon. 57Y. .�A Dated y.o ,C 19 92-•• OYA.ECKL Registered Land Surveyor Kodiak Island Borough Community Development Department 710 Mill Bay Rd. Rm 205 Kodiak AK 99615 Ph. (907) 486 - 9362 Fax (907) 486 - 9396 http://www.kodiakak.us Zoning Compliance Permit Print Form 1111 1111 16051 1 1 11 Permit No. CZ2010 -109 Property Owner/ Applicant: Mailing Address: Phone Number: Other Contact email, etc.: Legal Description: Street Address: The following information is to be supplied by the Applicant: Casey, Robt 1619 Lynden Way, Kodiak, AK 99615 1.907.512.3009 Elderberry Hgts 4th Bk 5 Lt 7 1619 Lynden Way Use & Size of Existing Structures: SFR —2,700 sqft (2 firs + basement) Description of Proposed Action: Interior remodel (add bath in office area - middle floor) Site Plan to include: Lot boundaries and existing easements, existing buildings, proposed location of new construction, access points, and vehicular parking areas. Staff Compliance Review: ZONING: R -2 Prop_ID 16051 Lot Area: 7,722 sqft Lot Width: 60' Bldg Height: 35 ' Front Yard: 25 ' Rear Yard: 10 ' Side Yard: 5 ' Prk'g Plan Rvw? No # of Req'd Spaces: 3 Plat / Subdivision Requirements? Does the project involve an EPA defined facility? N/A If YES, do you have an EPA Return Receipt of Notification? "Permit will not be issued until receipt is submitted to KIB" N/A Coastal Policy Residential Subd Case No. Driveway Permit? Septic Plan Approval: Fire Marshall: Consistent? Yes Attachment? Plat No. Bldg Permit No. Applicant Certification: I hereby certify that 1 will comply with the provisions of the Kodiak Island Borough Code and that I have the authority to certify this as the property owner, or as a representative of the property owner. 1 agree to have identifiable corner markers in place for verification of building setback (yard) requirements. Attachments? List Other: Date: Jun 4, 2010 Signature: Robert Casey This permit is only for the proposed project as described by the applicant. If there are any changes to the proposed project, including its intended use, prior to or during its siting, construction, or operation, contact this office immediately to determine if further review and approval of the revised project is necessary. ** EXPIRATION: A zoning compliance permit will become null and void if the building or use authorized by such permit is not commenced within 180 days from the date of issuance, or if the building construction or use is abandoned at any time, after the work is commenced, for a period of 180 days. Before such work can be recommenced, a new permit must first be obtained. (Sec. 106.4.4 Expiration. 1997 UBC) per KIBC 17.03.060. ** CDD Staff Certification Date: Jun 4, 2010 CDD Staff: Martin Ly Payment Verification Zoning Compliance Permit Fee Payable in Cashier's Office Room # 104 Fee Schedule JUN 4 Kodiak Is an Finance De Construction Disposal Deposit Payable in Cashier's Office Room # 104 Fee Schedule FICftSH 6/04/2010 100005229 Less than 250 sq ft $250.00 20 Bo'I it gh 3artment FI 8. :2e 11TIL YMT PA,i) 25.00 * ** Paid in Full * ** Kodiak Isla d Borough Kodiak 99615 (907) 48 -9324 APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANY - CITY OF KODIAK - KODIAK ISLAND BOROUGH - BUILDING DEPARTMENT Telephone: 486-8070 700 Mill Bay Road (APPLICANT TO FILL IN ALL INFORMATION WITHIN BOLD LINES. PLEASE PRINT. USE A BALLPOINT PEN AND PRESS FIRMLY.) (OFFICE USE ONLY) STREET ADDRESS: L//,/ //' , , (,,) CLASS AND SCOPE OF WORK: SPECIFICATIONS: BUILDING PERMIT NUMBER: DATE OF APPLICATION: ,'-- /I (7' .2_ LOT : BLOCK • / ' 1-`" ...) NEW DEMOLITION FOUNDATION FOOTINGS STEM WALL PIERS ZONING COMPLIANCE : DATE ISSUED: , C:2 `.-- r)7 4/ •5-//3- ALTERATION REPAIR TYPE SUBDIVISION /SURVEY: 4 4-1,-, 1 ,. /- \ / / 1- , -- . / i- / / ., r-, I -.. 411 ADDITION MOVE DIMENSIONS VALUATION BASIS: BUILDING PERMIT FEE: / 4- /7 7 r DEPTH IN GRND N NAME: , L.) i, • 7, , - 761••"7//717) M 4 // = •'''' ` ' USE OF BUILDING AUTHORIZED BY THIS PERMIT: cf.-Ci.----("Ze /.< c-- i.,-,--:1 •-,- —, .....-- ,/...1-‹ 42,-, ,---•'-'5, c'• il.4 ---„,- E ' >e b ' " REINFORCEMENT VALUATION: PLAN CHECK FEE: .-7 BOLT SPACING AI,LING ADDRESS: c f ,,..j , ,:;2 i CRAWL SPACE HEIGHT INCHES OCCUPANCY GROUP: TOTAL FEE: A B E H 1 M (11--_) DIV. 1 2 OD 4 5 6 Ts- CRAWL SPACE VENT SQ. FEET RECEIPT NO.: CITy,& STATE: L il I/ '-,.1 '717' , A' r - SIZE HEIGHT STRUCTURAL SPECIES & GRADE SIZE SPACING SPAN EACH OF THE FOLLOWING STAGES OF CONSTRUCTION REQUIRES INSPECTION BE REQUESTED & COMPLETED PRIOR TO PROCEEDING WITH ANY FURTHER WORK: FOR INSPECTION CALL 486-8070 O. OF ROOMS STORIES TELEPHONE : , 4,1,11, — , NO. OF FAMILIES GIRDERS TYPE OF BUSINESS 1 GIRDERS 1-! f c/ t= F , , • A R C H / E N G ■.--, PI T R A C T 0 R NAME: NO. OF SLOGS NOW ON LOT JOISTS 1ST FLOOR USE OF EXISTING 81L SIZE OF LOT STS 1ST FLOOR JOISTS 2ND FLOOR TYPE OF CONSTRUCTION_ I II III IV 1-HR FR H.T. WATER: PUBLIC PRIVATE 1 JOISTS 2ND FLOOR CITY & STATE: SEWER: PUBLIC PRIVATE I CEILING JOISTS /I F 2 , /7 , INSULATION TYPE & THICKNESS: EXTERIOR WA S , . EXCAVATION BEARING WALLS TELEPHONE : FOUNDATION UNDERGROUND UTILITIES INTERIOR WALLS DRIVEWAY PERMIT: FOUNDATION /SETBACKS SUBMITTED I / ,f APPROVED/// , ' FRAMING STATE LICENSE : WALLS ROOF RAFTERS (-1 ( y' ( q ROOF/CEILING TRUSSES ROUGH ELECTRICAL NAME: SHEATHING TYPE SIZE: FURNACE TYPE: �ROUGH PLUMBING FLOOR ADEC APPLICATION: FINAL SUBMITTED Al ,, // DATE C.O. ISSUED: WOOD HEATER YES NO MAILING ADDRESS: FINAL APPROWL / WALLS ALASKA FIREMARSHALL REVIEW: SUBMITTED: APPROVED: / CITY & STATE: ROOF TYPE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT IT IS CORRECT AND THAT,,A,AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING .ONSTRUCTION- / 1 ji APPLICANT: TELEPHONE : FINISH MATERIAL: ROOF ,-,- 'r71/.."4,-; APPRO vED-zBUILDING -OrFICAL: _ - STATE LICENSE : EXTERIOR SIDING INTERIOR WALLS NOTES: il i`t��� i. c . - ti •- t yti 3s_ ,„..r"—* t l .......• l 1✓ t... r_ w... UmM. ti F/ ao cN /cEJ F" 4/120.1747 /987 DEeks ADDEE =J co,2A,Eer .2ECoriaRr.0 -3� Ttwvsf©te 5 /1./A/' Ros szABf Z OF 4 OOO SP* FIELD CJ4ECKE0 and UP-DATED /9 dECEM.ER 1989 - STE-W CHANGED; AWOL TANK, r�T.4/N*NG WALL and Roe -eeRY .goo6P i/ELO CNECKEr, and UP -DATA, 22 J.A. NUARY 4992. (AppEp m MavE) AS BUILT SURVEY ni 13:14 +e ea a 11.. +� M .fi.+.....rJ:rK Roy A. &?::vad ... •i NO 161.3S 44 • 4 o hereby ce Lot 41-1* de4: ,,., u. s su #v2.y / ,00/ . 84 -L3 6. and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmis- sion lines or other visible easements on said property except as inch-. cated hereon. n Dated th' 4- .0 / ,19 , gOdESS ONA.'"�,+ ROY A. ECKLUN Registered Land Surveyor ODIAK IS 1 BOROUGH Community Development 204), Kodiak, Alaska 99615.6340 Phone: 486.5736, ZONING COMPLIANCE. PERMIT • #: �. G� —X_ ` 710 MiII Bay R. ; (Rm - (907) ext. 255 or 254 Permit • Z- .. 1. Property Own /Applicant: 'I / TD L Pafricia, /Q 64/ Number and size of parking spaces required (onsite identification of parking spaces is required - Yes: No: ) N/ r /�� ,/�/'� Mailing Address: � 4i1" lia-/ /�'� Phone: 4'ZL9�"" 77W I © 6(� 3 � �=t � � -� �^i�!'"fl�� � ,- 1 �-// 2. Legal Description: LO/ 7 L�' .0 Vo%^JP.re! h 5-(A.141/ . Off- street loading requirement: r / Street Address: /(.2 /9 Cy%?LI `/1 vVG Tax Code #: 12- , 4 --2-2--L Y� 1) -4- Plat related requirements (e.g., plat notes, easements, subdivision conditions, etc.): 3. Description of Existing Property /current zoning: 12 U ,4,— Minimum Required Lot Area: 2 , /- -•{ --7 Width: C-? � Other requirements (e.g., zero lot line, additional setbacks, projections into yards, screening, etc.): Actual Lot Area: 7 7 z Width: - " - ` K _s_ -)--:`- r_- 1 Minimum Required Setbacks: Sides: ('- ' Front: ���' r Rear: Coastal Management Program Applicable Polices (check appropriate category) - Residential: Vii Business: Maximum Building Height:• Industrial: Other (list): Use and size of existing structures on the lot 7 $ 2 G' s / -- 11 . Is the proposed action consistent with the KIB Coastal Management Program? - Yes: ter/ No: If the proposed action conflicts with the Coastal Management Program policies, attach a sheet that notes the policy(ies), describes the conflict(s), and specifies conditions to mitigate the conflict(s). Attachment - Yes: No: v/ 4. Description of proposed action (attach site plan): ...:R—k:-. q & { % �,•� � .�.� , - • �r" �� Appl'ca t ertification: I h certify that I will comply with the provisions of the Kodiak Island Borough Code and that I have the authority to certify this as the property owner, or as a representative of the property owner. I agr• - to dentifiable comer r rs m place in the field for verification of setbacks. By: z - C " `' �\ / / Date: 6- ----2 - Title: Supporting documents attached (check): Site plan: As-built survey:_ Other (list): ± -. t • .! q• h �' 6. Community Development staff for zoning, - ti b1' s�' =- Date: --�- ,J Title: .J-c2< J� 7. Fire Chief (City of Kodiak, Fire District 11 (Bayside), Womens Bay Fire District) approval for UFC (Sections 10.207 and 10.301C) by: Date: $. Driveway Permit (State, Gly of Kodiak, Borough) issued by: Date: 9. Septic system PLAN approved by: Date: Distribution: File/Building official/ApplicantTHIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING PERMIT IS REQUIRED )une 1991 �+� 1( • I r ./ • rs ..'. 1 1•. • - ots s§' F"/ ELO c// /cfI> ;t:' UPDA7 I9 4.5.FP7 /987 J oEtles A ©P.Ev zJ co/LvEEr .eECovGe60 3� TaA, rioalso t f MM/ /9o$ SL4BS Tlv. FIELQ Cl4ECKED an 1 UP-DATEL /9 pa-aEMh3ER 1989 - erePs awls IGED; PVEL. TANK,/ ETA /N /NG WALL and ROCKERY 40 .06D - P/EL17 CHECKED and UP -DATA, 2Z JANUARY / 992- (AVVEC r4 PO/V,E) AS - BUILT SURVEY I hereby certify that I have surveyed the following described roperty- Lot? u off . U. 5. eery / s1o. 84 -Z3 and that the improvements situated thcrc•onare within the property lines and do not overlap or encroach on the property Tying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmis- sion lines or, other visible easements on said property except as indi -. cated hereon. Dated th' �_ ROY A. ECKLUN Registered Land Surveyor ,19 92- raven b • 5. er Date: /71u/ John Yager 203 D Avenue #B Kodiak, Alaska 99615 Dear Mr. Yager: Kodiak Island Borough P.O. BOX 1246 KODIAK, ALASKA 99615-1246 PHONE (907) 486-5736 September 26, 1988 The City of Kodiak has informed the Community Development Department that you have been issued a certificate of authority to collect sales tax for a residential rental located at 1619 Lynden Way, legally described as Lot 7, Block 5, Elderberry Heights 4th Addition, and currently zoned R2--Two-Family Residential. The rental of this residential property as a single-family dwelling is allowed as long as you meet all the standards contained in the attached administrative interpretation. If you do not meet these standards, please contact the Kodiak Island Borough Community Development Department within fifteen (15) days of the date of this letter to discuss the rental of this property. If we do not hear from you, we will assume that your rental of this property meets all of the standards of the Kodiak Island Borough Zoning Code. If you have any questions regarding why your rental must comply with the Borough Zoning Ordinance, please do not hesitate to contact the Community Development Department at 486-5736. Sincerely, Linda L. Freed, Director Community Development Department attachment: Administrative Interpretation r 3 TO: CITY OF KODIAK P.O.BOX 1397 KODIAK, ALASKA 99615 APP- _- _ITION FOR CERTIFICATE OF REGISTR____ON (SALES AND SERVICE TAX) / DATE OF APPLICATION T-. CONFIDENTIAL ACCOUNT NO. %%= NAME OF FIRM LOCATION ADDRESS MAILING ADDRESS NAME OF OWNER HOME ADDRESS 16) Iq ( AiD -4J Wi ao3 Au ie 4 L KobIH K AK (J BUSINESS PHONE STREET �OF1 Vi/c —f CITY STATE ZIP CODE c9G3T Ave_ STREET TYPE OF BUSINESS W7c6e M:"%%/// c-4 / DATE BUSINESS STARTED fiK (f61 HOME PHONE(�/O7)�(S y763' CITY STATE ZIP CODE ALASKA BUSINESS LICENSE NUMBER TYPE OF ORGANIZATION: x INDIVIDUAL PARTNERSHIP CORPORATION OTHER (EXPLAIN BELOW) IS BUSINESS SEASONAL IF YES, APPROXIMATE DATES THAT BUSINESS IS OPERATED EACH YEAR FROM TO NO. OF MONTHS SIGNAf URE & TITLE OF APPLICANT NAME TITLE MAILING ADDRESS: HOME ADDRESS: PHONE: NAME TITLE MAILING ADDRESS: HOME ADDRESS: PHONE: NAME TITLE MAILING ADDRESS: HOME ADDRESS: PHONE: NAME TITLE MAILING ADDRESS: HOME ADDRESS: PHONE: REVENUE OFFICE White copy: File Yellow copy: Building Permit Pink copy: Applicant ZONING COMPLIANCE PERMIT 1. PROPERTY OWNER /APPLICANT Name: J0 4 W. YYGEj K^Ai�' Island Borough C unity Development Department 710 Mill Bay Road, Room 204 Kodiak, Alaska 99615 (907)486 -5736 Ext. 255 Zoning Compliance #: Address: �� L /M O EN WA -y KQp►{LK t AK 9 1/o IS Telephone: (6107) A486-6373 2. LEGAL DESCRIPTION OF PROPERTY Street Address: 1(0 l G Lyni DEN \n%Ay Lot, block, subdivision: LOT SEYEN (7) e <A /I/E (.5)` E�Egii'EAM/ fiE/(r/las se/AT: % /S /a FoN/ZT/,i rT/ON, AKO4'Pl Tb pLA78q- Survey, other (e.g. township /range): Tax code #: (2_ 14 G9- 05 OO7 3. DESCRIPTION OF EXISTING PROPERTY Zoning: 4,( La_ Square footage of lot: %7zz s Minimum lot width: Average lot depth: Average lot width: Lot depth to width ratio: Use and size of existing buildings on the lot: Z • 5.}phy Fratme I-�i t,<<SG 8�0 s� P 5.r/L. / No Minimum Setbacks — Front: 4. DESCRIPTION OF PROPOSED ACTION (attach site plan) A4a ch a0 ` X 191 Ga na qe -b —r t° �r,r n e-• (4- 1-►ouse • 5. ZONING REQUIREMENTS FOR NEW CONSTRUCTION Type of structure(s): 1 No Minimum Setbacks — Front: Rear: 0 C Sides: CJ 1 Additional Setbacks: /l.) •/� t Maximum into required (Z 05-3 projection(s) yards; Maximum building height: 3 4I Maximum lot coverage: � .,/_ Number and size of parking spaces required: -e3-. 5, t NI ge5 ( 5 Rstre- Off-street loading requirement: Plat related requirement(s): Other (e.g. zero lot line): 6. CONSISTENCY WITH COASTAL MANAGEMENT PROGRAM Applicable policies: �t(,,ST ,AA- — 44— t — Proposed action consistent with Borough Coastal Management Program — Yes No Proposed action conflicts with policies (note policy and describe conflict): Conditions attached to Consistency approval to mitigate conflicts noted above: 7. APPLICANT CERTIFICATION I hearby certify that I will comply with all provisions of the Kodiak Island Borough Code and that I have the authority to certify this as owner, or representative of the owner, of the property(s) involved. Signed Title d Date /0/88 8. SUPPORT DOCUMENTS ATTACHED Site Plan: A. Other: As_ Arit./liT 9. BOROUGH STAFF AP ROVAL Staff Approval: Signed Title Date Building permit #: Z3 Scale: 114- 2 0 7 4 : 2 2 r/ ELO GNECk P £ [/P047EO 4.5,EP7- /987 oEc.ks ,a ooEd eJ coy ipe-er IECot4�4e4go 3) 71742.yrfr -oRm it f MA/L /lax SLABS ns - r3iiT SUflVY T /.D . hereby certify that 1 have surveyed the following described cz property) Lot 7, black 5, E /drberr,-/ 57s. , -4-7'47 A Idi1. U- 5. Su/VIZAI /x}96 • A'/a71 s-,.0 . 84 - Z °S and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property Tying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmis- sion lines or other visible easements on said property except as indi- cated hereon. Dated this 7 day of �er" 19 ? 7 r 1 j/- /,._.4 f ROY A. ECKLUNL Registered Land Surveyor Drawn by: 5..4cr.5i ,,r? ' ? Date: /7 Old,/ /9235 BUILDING DEPARTMENT — CITY / BOROUGH OF KODIAK APPLICATION FOR BUILDING PERMIT AND CERTIFICATE Applicant to fill in between heavy lines. OF OCCUPANCY BUILDING ADDRESS CLASS OF WORK NEW DEMOLISH LOCALITY ALTERATION REPAI R NEAREST CROSS ST. ADDITION MOVE BUILDING PERMIT NO DATE ISSUED USE OF BUILDING ce Z 0 NAME SIZE OF BUILDING HEIGHT MAIL ADDRESS NO. OF ROOMS NO. OF FLOORS CITY TEL. NO. NO. OF BUILDINGS VALUATION BLDG. FEE PLAN CHK. FEE TOTAL ENGINEER NAME NO. OF BUILDINGS NOW ON LOT BUILDING PLUMBING ELECTRIC NO. OF FAMILIES FOUNDATION ROUGH ROUGH ADDRESS SIZE OF LOT FRAME SEPTIC TANK FINISH CITY USE OF BLDG. NOW ON LOl PLASTER SEWER FIXTURES SPECIFICATIONS FLUES GAS MOTORS STATE LICENSE NO. FOUNDATION FINAL FINISH FINAL K 0 F U Q 1- F Z 0 U NAME MATERIAL EXTERIOR, PIERS WIDTH OF TOP ADDRESS WIDTH OF BOTTOM CITY DEPTH IN GROUND R . PLATE (SILL) STATE LICENSE NO. ZE SPA. , SUBDIVISION GIRDERS JOIST 1st. FL, JOIST 2nd. FL. LOT NO. BLK. JOIST CEILING EXTERIOR STUDS DO NOT WRITE BELOW THIS LINE 1. Type of Construction I, 11, 111, IV, V, VI 2. Occupancy Group A, B, C, D, E, F, G, H, I, J Div. 1, 2, 3, 4, 3. Fire Zone 1 2 3 4 INTERIOR STUDS ROOF RAFTERS BEARING WALLS COVERING EXTERIOR WALLS ROOF INTERIOR WALLS REROOFING FLUES FIREPLACE FL. FURNACE KITCHEN WATER HEATER FURNACE GAS OIL I hereby acknowledge that I have read this application and state that the above is correct and agree to comply with all City Ordinances and State Laws regulating building constructiori. Applicant 3N1-1 Al2J3dO2id PLOT PLAN A I SETBACK 3N11 Al J3dOl=1d STREET PLANNING & ZONING INFO. ZONING DISTRICT -.TYPE OF OCCUPANCY NUMBER OF STORIES TOTAL HT. AREA OF LOT FRONT YARD SETBACK FROM PROP. LINE SIDE YARD SETBACK FROM PROP. LINE REAR YARD Approved: CHIEF BUILDING OFFICAL Approved: ZONING ADMINISTRATOR By: By: